J Rheum Dis.  2015 Feb;22(1):10-18. 10.4078/jrd.2015.22.1.10.

Diet and Folk Medicines for Rheumatic Diseases

• Kim GT

• KMID: 2222921
• DOI: http://doi.org/10.4078/jrd.2015.22.1.10

Abstract

Notwithstanding recent advances in the field of treatment of rheumatic diseases, patients still have a significant interest in complementary and alternative medicine for various reasons. The purpose of this review is to investigate the effect of certain dietary components or folk medicines on the pathogenesis or outcome of rheumatic diseases. The data used in the study were mainly selected from the references searched by MEDLINE. Among the variety of dietary components and folk medicines investigated, omega-3 fatty acid, alcohol, and vitamin D showed negative correlation with the risk of rheumatoid arthritis. Specifically, omega-3 fatty acids appeared to be somewhat helpful for treatment of rheumatoid arthritis. Although some of the items showed a positive effect through this study, it failed to establish definitive evidence for the overall effect of diet and folk medicines in rheumatic diseases. In the future, further understanding of mechanisms and clinical utility should be acquired through numerous systematic and scientific research studies.

Keyword

Diet; Traditional medicine; Rheumatic diseases

MeSH Terms

Arthritis, Rheumatoid
Complementary Therapies
Diet*
Fatty Acids, Omega-3
Humans
Medicine, Traditional
Rheumatic Diseases*
Vitamin D
Fatty Acids, Omega-3
Vitamin D

Figure

• 

  Figure 1. Anti-inflammatory effect of omega-3 fatty acid. APC: antigen-presenting cell, DHA: docosahexaenoic acid, EPA: eicosapentaenoic acid, MHC: major histocompatibility complex.

• 

  Figure 2. Anti-inflammatory effect of vitamin D. DC: dendritic cell, diff.: differentiation, Ig: immunoglobulin, IL: interleukin, MHC: major histocompatibility complex, TNF-α: tumor necrosis factor-α.

• 

  Figure 3. Anti-inflammatory effect of probiotics. DC: dendritic cell, NF-κ B: nuclear factor-κ B, Treg: regulatory T cells.

Reference

1. Sugiyama D, Nishimura K, Tamaki K, Tsuji G, Nakazawa T, Morinobu A, et al. Impact of smoking as a risk factor for developing rheumatoid arthritis: a metaanalysis of observational studies. Ann Rheum Dis. 2010; 69:70–81.

2. Choi HK. Diet and rheumatoid arthritis: red meat and beyond. Arthritis Rheum. 2004; 50:3745–7.

3. Volker DH, FitzGerald PE, Garg ML. The eicosapentaenoic to docosahexaenoic acid ratio of diets affects the pathogenesis of arthritis in Lew/SSN rats. J Nutr. 2000; 130:559–65.

4. Ierna M, Kerr A, Scales H, Berge K, Griinari M. Supplementation of diet with krill oil protects against experimental rheumatoid arthritis. BMC Musculoskelet Disord. 2010; 11:136.

5. Linos A, Kaklamanis E, Kontomerkos A, Koumantaki Y, Gazi S, Vaiopoulos G, et al. The effect of olive oil and fish consumption on rheumatoid arthritis: a case control study. Scand J Rheumatol. 1991; 20:419–26.

6. Pedersen M, Stripp C, Klarlund M, Olsen SF, Tjønneland AM, Frisch M. Diet and risk of rheumatoid arthritis in a prospective cohort. J Rheumatol. 2005; 32:1249–52.

7. Shapiro JA, Koepsell TD, Voigt LF, Dugowson CE, Kestin M, Nelson JL. Diet and rheumatoid arthritis in women: a possible protective effect of fish consumption. Epidemiology. 1996; 7:256–63.

8. Rosell M, Wesley AM, Rydin K, Klareskog L, Alfredsson L. EIRA study group. Dietary fish and fish oil and the risk of rheumatoid arthritis. Epidemiology. 2009; 20:896–901.

9. Di Giuseppe D, Wallin A, Bottai M, Askling J, Wolk A. Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: a prospective cohort study of women. Ann Rheum Dis. 2014; 73:1949–53.

10. Goldberg RJ, Katz J. A metaanalysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007; 129:210–23.

11. Lee YH, Bae SC, Song GG. Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a metaanalysis. Arch Med Res. 2012; 43:356–62.

12. Proudman SM, James MJ, Spargo LD, Metcalf RG, Sullivan TR, Rischmueller M, et al. Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use. Ann Rheum Dis. 2015; 74:89–95.

13. Zainal Z, Longman AJ, Hurst S, Duggan K, Caterson B, Hughes CE, et al. Relative efficacies of omega-3 polyunsaturated fatty acids in reducing expression of key proteins in a model system for studying osteoarthritis. Osteoarthritis Cartilage. 2009; 17:896–905.

14. Baker KR, Matthan NR, Lichtenstein AH, Niu J, Guermazi A, Roemer F, et al. Association of plasma n-6 and n-3 polyunsaturated fatty acids with synovitis in the knee: the MOST study. Osteoarthr Cartil. 2012; 20:382–7.

15. Cutolo M, Otsa K, Uprus M, Paolino S, Seriolo B. Vitamin D in rheumatoid arthritis. Autoimmun Rev. 2007; 7:59–64.

16. Doria A, Arienti S, Rampudda M, Canova M, Tonon M, Sarzi-Puttini P. Preventive strategies in systemic lupus erythematosus. Autoimmun Rev. 2008; 7:192–7.

17. Costenbader KH, Feskanich D, Holmes M, Karlson EW, Benito-Garcia E. Vitamin D intake and risks of systemic lupus erythematosus and rheumatoid arthritis in women. Ann Rheum Dis. 2008; 67:530–5.

18. Hiraki LT, Munger KL, Costenbader KH, Karlson EW. Dietary intake of vitamin D during adolescence and risk of adult-onset systemic lupus erythematosus and rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012; 64:1829–36.

19. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG. Iowa Women's Health Study. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women's Health Study. Arthritis Rheum. 2004; 50:72–7.

20. Song GG, Bae SC, Lee YH. Association between vitamin D intake and the risk of rheumatoid arthritis: a metaanalysis. Clin Rheumatol. 2012; 31:1733–9.

21. Cantorna MT, Hayes CE, DeLuca HF. 1,25-Dihydroxychol-ecalciferol inhibits the progression of arthritis in murine models of human arthritis. J Nutr. 1998; 128:68–72.

22. Brohult J, Jonson B. Effects of large doses of calciferol on patients with rheumatoid arthritis. A double-blind clinical trial. Scand J Rheumatol. 1973; 2:173–6.

23. Andjelkovic Z, Vojinovic J, Pejnovic N, Popovic M, Dujic A, Mitrovic D, et al. Disease modifying and immunomodulatory effects of high dose 1 alpha (OH) D3 in rheumatoid arthritis patients. Clin Exp Rheumatol. 1999; 17:453–6.

24. Salesi M, Farajzadegan Z. Efficacy of vitamin D in patients with active rheumatoid arthritis receiving methotrexate therapy. Rheumatol Int. 2012; 32:2129–33.

25. Matsumoto Y, Sugioka Y, Tada M, Okano T, Mamoto K, Inui K, et al. Relationships between serum 25-hydroxycalciferol, vitamin D intake and disease activity in patients with rheumatoid arthritis: TOMORROW study. Mod Rheumatol. 2014; Sep 11 [Epub].DOI:. http://dx.doi.org/10.3109/14397595.2014.952487.

26. Felson DT, Niu J, Clancy M, Aliabadi P, Sack B, Guermazi A, et al. Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum. 2007; 56:129–36.

27. Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G. Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum. 2009; 60:1381–9.

28. Merry P, Winyard PG, Morris CJ, Grootveld M, Blake DR. Oxygen free radicals, inflammation, and synovitis: and synovitis: the current status. Ann Rheum Dis. 1989; 48:864–70.

29. Halliwell B. Oxygen radicals, nitric oxide and human inflammatory joint disease. Ann Rheum Dis. 1995; 54:505–10.

30. Karatas F, Ozates I, Canatan H, Halifeoglu I, Karatepe M, Colakt R. Antioxidant status & lipid peroxidation in patients with rheumatoid arthritis. Indian J Med Res. 2003; 118:178–81.

31. Pattison DJ, Silman AJ, Goodson NJ, Lunt M, Bunn D, Luben R, et al. Vitamin C and the risk of developing inflammatory polyarthritis: prospective nested case-control study. Ann Rheum Dis. 2004; 63:843–7.

32. Karlson EW, Shadick NA, Cook NR, Buring JE, Lee IM. Vitamin E in the primary prevention of rheumatoid arthritis: the Women's Health Study. Arthritis Rheum. 2008; 59:1589–95.

33. Costenbader KH, Kang JH, Karlson EW. Antioxidant intake and risks of rheumatoid arthritis and systemic lupus erythematosus in women. Am J Epidemiol. 2010; 172:205–16.

34. Edmonds SE, Winyard PG, Guo R, Kidd B, Merry P, Langrish-Smith A, et al. Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double blind trial. Ann Rheum Dis. 1997; 56:649–55.

35. Peretz A, Siderova V, Nève J. Selenium supplementation in rheumatoid arthritis investigated in a double blind, place-bo-controlled trial. Scand J Rheumatol. 2001; 30:208–12.

36. Bae SC, Jung WJ, Lee EJ, Yu R, Sung MK. Effects of antioxidant supplements intervention on the level of plasma inflammatory molecules and disease severity of rheumatoid arthritis patients. J Am Coll Nutr. 2009; 28:56–62.

37. Wang Y, Hodge AM, Wluka AE, English DR, Giles GG, O'Sullivan R, et al. Effect of antioxidants on knee cartilage and bone in healthy, middle-aged subjects: a cross-sectional study. Arthritis Res Ther. 2007; 9:R66.

38. Nowak B, Ciszek-Lenda M, Sróttek M, Gamian A, Kontny E, Górska-Frączek S, et al. Lactobacillus rhamnosus exopolysaccharide ameliorates arthritis induced by the systemic injection of collagen and lipopolysaccharide in DBA/1 mice. Arch Immunol Ther Exp (Warsz). 2012; 60:211–20.

39. Hatakka K, Martio J, Korpela M, Herranen M, Poussa T, Laasanen T, et al. Effects of probiotic therapy on the activity and activation of mild rheumatoid arthritis: a pilot study. Scand J Rheumatol. 2003; 32:211–5.

40. Jenks K, Stebbings S, Burton J, Schultz M, Herbison P, Highton J. Probiotic therapy for the treatment of spondyloarthritis: a randomized controlled trial. J Rheumatol. 2010; 37:2118–25.

41. Pineda Mde L, Thompson SF, Summers K, de Leon F, Pope J, Reid G. A randomized, double-blinded, placebo-controlled pilot study of probiotics in active rheumatoid arthritis. Med Sci Monit. 2011; 17:CR347–54.

42. Mandel DR, Eichas K, Holmes J. Bacillus coagulans: a viable adjunct therapy for relieving symptoms of rheumatoid arthritis according to a randomized, controlled trial. BMC Complement Altern Med. 2010; 10:1.

43. Alipour B, Homayouni-Rad A, Vaghef-Mehrabany E, Sharif SK, Vaghef-Mehrabany L, Asghari-Jafarabadi M, et al. Effects of Lactobacillus casei supplementation on disease activity and inflammatory cytokines in rheumatoid arthritis patients: a randomized double-blind clinical trial. Int J Rheum Dis. 2014; 17:519–27.

44. Grant WB. The role of meat in the expression of rheumatoid arthritis. Br J Nutr. 2000; 84:589–95.

45. Benito-Garcia E, Feskanich D, Hu FB, Mandl LA, Karlson EW. Protein, iron, and meat consumption and risk for rheumatoid arthritis: a prospective cohort study. Arthritis Res Ther. 2007; 9:R16.

46. Pattison DJ, Symmons DP, Lunt M, Welch A, Luben R, Bingham SA, et al. Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption. Arthritis Rheum. 2004; 50:3804–12.

47. Heliövaara M, Aho K, Knekt P, Impivaara O, Reunanen A, Aromaa A. Coffee consumption, rheumatoid factor, and the risk of rheumatoid arthritis. Ann Rheum Dis. 2000; 59:631–5.

48. Mikuls TR, Cerhan JR, Criswell LA, Merlino L, Mudano AS, Burma M, et al. Coffee, tea, and caffeine consumption and risk of rheumatoid arthritis: results from the Iowa Women's Health Study. Arthritis Rheum. 2002; 46:83–91.

49. Formica MK, Palmer JR, Rosenberg L, Mcalindon TE. Lifestyle factors associated with the development of rheumatoid arthritis (RA): results for the Black Women's Health Study (BWHS). Arthritis Rheum. 2001; 44(Suppl 9):S376.

50. Karlson EW, Mandl LA, Aweh GN, Grodstein F. Coffee consumption and risk of rheumatoid arthritis. Arthritis Rheum. 2003; 48:3055–60.

51. Lee YH, Bae SC, Song GG. Coffee or tea consumption and the risk of rheumatoid arthritis: a metaanalysis. Clin Rheumatol. 2014; 33:1575–83.

52. Ahmed S. Green tea polyphenol epigallocatechin 3-gallate in arthritis: progress and promise. Arthritis Res Ther. 2010; 12:208.

53. Jonsson IM, Verdrengh M, Brisslert M, Lindblad S, Bokarewa M, Islander U, et al. Ethanol prevents development of destructive arthritis. Proc Natl Acad Sci U S A. 2007; 104:258–63.

54. Khoruts A, Stahnke L, McClain CJ, Logan G, Allen JI. Circulating tumor necrosis factor, interleukin-1 and interleukin-6 concentrations in chronic alcoholic patients. Hepatology. 1991; 13:267–76.

55. Szabo G, Mandrekar P, Girouard L, Catalano D. Regulation of human monocyte functions by acute ethanol treatment: decreased tumor necrosis factor-alpha, interleukin-1 beta and elevated interleukin-10, and transforming growth factor-beta production. Alcohol Clin Exp Res. 1996; 20:900–7.

56. Imhof A, Froehlich M, Brenner H, Boeing H, Pepys MB, Koenig W. Effect of alcohol consumption on systemic markers of inflammation. Lancet. 2001; 357:763–7.

57. Maxwell JR, Gowers IR, Moore DJ, Wilson AG. Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis. Rheumatology (Oxford). 2010; 49:2140–6.

58. Lu B, Solomon DH, Costenbader KH, Keenan BT, Chibnik LB, Karlson EW. Alcohol consumption and markers of inflammation in women with preclinical rheumatoid arthritis. Arthritis Rheum. 2010; 62:3554–9.

59. Nissen MJ, Gabay C, Scherer A, Finckh A. Swiss Clinical Quality Management Project in Rheumatoid Arthritis. The effect of alcohol on radiographic progression in rheumatoid arthritis. Arthritis Rheum. 2010; 62:1265–72.

60. Jin Z, Xiang C, Cai Q, Wei X, He J. Alcohol consumption as a preventive factor for developing rheumatoid arthritis: a doseresponse metaanalysis of prospective studies. Ann Rheum Dis. 2014; 73:1962–7.

61. Scott IC, Tan R, Stahl D, Steer S, Lewis CM, Cope AP. The protective effect of alcohol on developing rheumatoid arthritis: a systematic review and metaanalysis. Rheumatology (Oxford). 2013; 52:856–67.

62. Mani S, Lawson JW. In vitro modulation of inflammatory cytokine and IgG levels by extracts of Perna canaliculus. BMC Complement Altern Med. 2006; 6:1.

63. Lawson BR, Belkowski SM, Whitesides JF, Davis P, Lawson JW. Immunomodulation of murine collagen-induced arthritis by N, N-dimethylglycine and a preparation of Perna canaliculus. BMC Complement Altern Med. 2007; 7:20.

64. Cobb CS, Ernst E. Systematic review of a marine nutriceutical supplement in clinical trials for arthritis: the effectiveness of the New Zealand green-lipped mussel Perna canaliculus. Clin Rheumatol. 2006; 25:275–84.

65. Furse RK, Rossetti RG, Zurier RB. Gammalinolenic acid an unsaturated fatty acid with antiinflammatory properties, blocks amplification of IL-1 beta production by human monocytes. J Immunol. 2001; 167:490–6.

66. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med. 1993; 119:867–73.

67. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with blackcurrant seed oil. Br J Rheumatol. 1994; 33:847–52.

68. Zurier RB, Rossetti RG, Jacobson EW, DeMarco DM, Liu NY, Temming JE, et al. Gamma-Linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum. 1996; 39:1808–17.

69. Reed GW, Leung K, Rossetti RG, Vanbuskirk S, Sharp JT, Zurier RB. Treatment of rheumatoid arthritis with marine and botanical oils: an 18-month, randomized, and double-blind trial. Evid Based Complement Alternat Med. 2014; 2014:857456.

70. Okamoto Y, Hara T, Ebato T, Fukui T, Masuzawa T. Brazilian propolis ameliorates trinitrobenzene sulfonic acid-induced colitis in mice by inhibiting Th1 differentiation. Int Immunopharmacol. 2013; 16:178–83.

71. Tanaka M, Okamoto Y, Fukui T, Masuzawa T. Suppression of interleukin 17 production by Brazilian propolis in mice with collagen-induced arthritis. Inflammopharmacology. 2012; 20:19–26.

72. Funk JL, Frye JB, Oyarzo JN, Kuscuoglu N, Wilson J, McCaffrey G, et al. Efficacy and mechanism of action of turmeric supplements in the treatment of experimental arthritis. Arthritis Rheum. 2006; 54:3452–64.

73. Funk JL, Oyarzo JN, Frye JB, Chen G, Lantz RC, Jolad SD, et al. Turmeric extracts containing curcuminoids prevent experimental rheumatoid arthritis. J Nat Prod. 2006; 69:351–5.

74. Takahashi Y, Tanaka M, Murai R, Kuribayashi K, Kobayashi D, Yanagihara N, et al. Prophylactic and therapeutic effects of Acanthopanax senticosus Harms extract on murine collagen-induced arthritis. Phytother Res. 2014; 28:1513–9.

75. Nordström DC, Honkanen VE, Nasu Y, Antila E, Friman C, Konttinen YT. Alpha-linolenic acid in the treatment of rheumatoid arthritis. A double-blind, placebo-controlled and randomized study: flaxseed vs. safflower seed. Rheumatol Int. 1995; 14:231–4.

76. Ahn YH, Oh JM, Lee MS, Jung JH, Chae SU, Moon SY, et al. Effect of water extract of Cynanchi wilfordii Radix in RANKL-induced osteoclast differentiation. Korean J Orient Physiol Pathol. 2012; 26:160–5.